State Variation in Health Care Service Utilization: United States, 2014

May 5, 2016

State-level differences in the percentage of uninsured Americans, along with other factors, may affect health care access and utilization.

An NCHS report examines the prevalence of two health care utilization measures among adults aged 18–64 by state. Additionally, differences by Medicaid expansion status and state Health Insurance Marketplace type are examined.

Findings: 

  • The percentage of adults without a usual place of medical care ranged from 2.8% in Vermont to 26.7% in Nevada.
  • The percentage of adults who did not have a general doctor visit in the past 12 months ranged from 15.9% in Vermont to 48.1% in Montana.
  • The percentage of adults without a usual place of medical care was lower in states that expanded Medicaid compared with nonexpansion states.
  • The percentage of adults without a usual place of medical care or who did not see a general doctor in the past 12 months was lower in states with partnership marketplaces compared with Federally Facilitated Marketplace states.

Access to Care Among Adults Aged 18–64 With Serious Psychological Distress

May 5, 2016

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Between 2013 and the first 9 months of 2015 almost 15 million adults aged 18–64 gained health insurance coverage in the United States. In monitoring the effects of this shift in coverage, one population of special interest is those with mental health conditions.

Previous studies have shown adults with mental health conditions have greater health care needs and are at higher risk for poor health outcomes, but may have reduced access to services.

A new NCHS report provides estimates of health care access and utilization for adults aged 18–64 with and without serious psychological distress in the past 30 days, an indicator of mental health problems severe enough to cause moderate-to-serious impairment in social, occupational, or school functioning and to require treatment. Estimates were based on data from the National Health Interview Survey for January 2012 through September 2015.

Findings:

  • Among adults aged 18–64 with serious psychological distress, the percentage who were uninsured decreased from 28.1% in 2012 to 19.5% in the first 9 months of 2015. Adults without serious psychological distress saw a decrease in the percentage of uninsured from 20.3% in 2012 to 12.3% in the first 9 months of 2015.
  • Although more adults with serious psychological distress have public rather than private coverage, the percentage with public coverage has remained relatively stable from 2012 through the first 9 months of 2015 while the percentage with private coverage has increased over the same time
    period.
  • The percentage of adults with serious psychological distress who have seen a mental health care professional in the past 12 months has declined from 2012 to the first 9 months of 2015.
  • In the first 9 months of 2015, 24.4% of adults with serious psychological distress and 6.1% of those without serious psychological distress had not received needed medical care due to cost.
  • The percentage of adults with serious psychological distress who needed mental health care but could not afford it declined from 2012 to the first 9 months of 2015.

Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January–September 2015

February 10, 2016

A new NCHS report presents selected estimates of health insurance coverage for the civilian noninstitutionalized U.S. population based on data from the January–September 2015 National Health Interview Survey (NHIS), along with comparable estimates from the 2010–2014 NHIS.

Estimates for 2015 are based on data for 79,847 persons.

Findings:

  • The number of uninsured persons has declined in the past 2 years. In the first 9 months of 2015, 28.8 million persons of all ages (9.1%) were uninsured at the time of interview—7.2 million fewer persons than in 2014 and 16.0 million fewer than in 2013.
  • Among adults aged 18–64, the percentage uninsured decreased from 16.3% in 2014 to 12.9% in the first 9 months of 2015. A corresponding increase was seen in the percentage with private coverage, from 67.3% to 70.0%, respectively. In 2013, among adults aged 18–64, 20.4% were uninsured and 64.2% had private coverage.
  • Among children under age 18 years, the percentage with private coverage increased from 52.6% in 2013 to 55.1% in the first 9 months of 2015.
  • Among those under age 65, the percentage with private coverage through the Health Insurance Marketplace or state-based exchanges increased from 2.5% (6.7 million) in the fourth quarter of 2014 to 4.2% (11.3 million) in the third quarter of 2015 (July–September).

Number of Uninsured in U.S. Continues to Decline

November 6, 2015

NCHS has released selected estimates of health insurance coverage for the civilian noninstitutionalized U.S. population based on data from the January–June 2015 National Health Interview Survey (NHIS), along with comparable estimates from the 2010–2014 NHIS.

Key Findings:

  • In the first 6 months of 2015, 28.5 million persons of all ages (9%) were uninsured at the time of interview—7.5 million fewer persons than in 2014 and 16.3 million fewer than in 2013.
  • Among adults aged 18–64, the percentage uninsured decreased from 16.3% in 2014 to 12.7% in the first 6 months of 2015. There was a corresponding increase in private coverage, from 67.3% to 70.6%. In 2013, among adults aged 18–64, 20.4% were uninsured and 64.2% had private coverage.
  • Among children under age 18 years, the percentage with private coverage increased from 52.6% in 2013 to 56.0% in the first 6 months of 2015, reversing a 14-year trend of declining rates of private coverage.
  • Among those under age 65, the percentage with private coverage through the Health Insurance Marketplace or state-based exchanges increased from 2.5% (6.7 million) in the fourth quarter of 2014 to 4.0% (10.7 million) in the second quarter

Health Care Access and Utilization Among Adults Aged 18–64, by Race and Hispanic Origin: United States, 2013 and 2014

July 15, 2015

In 2014, U.S. adults could buy a private health insurance plan through the Health Insurance Marketplace or state-based exchanges established as part of the Affordable Care Act. Moreover, some states opted to expand Medicaid coverage to low-income adults.

This report has data from the 2013 and 2014 National Health Interview Survey used to describe recent changes in health insurance coverage and selected measures of health care access and utilization for adults aged 18–64, by race and Hispanic origin.

Key Findings from the Report:

  • Compared with 2013, adults aged 18–64 who were uninsured at the time of interview decreased in 2014 for Hispanic (41.1% to 34.1%), non-Hispanic white (14.5% to 11.5%), non-Hispanic black (24.7% to 17.6%), and non-Hispanic Asian (16.1% to 12.1%) adults.
  • Adults aged 18–64 who had a usual place to go for medical care increased in 2014 for Hispanic (69.1% to 73.0%) and non-Hispanic white (84.3% to 85.6%) adults.
  • Adults aged 18–64 who had seen or talked to a health care professional in the past 12 months increased in 2014 for Hispanic (67.5% to 70.1%) adults.
  • Adults aged 18–64 who did not obtain needed medical care due to cost at some time during the past 12 months decreased in 2014 for Hispanic (9.9% to 7.6%) and non-Hispanic white (7.7% to 7.0%) adults.

 


Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, 2014

June 23, 2015

NCHS has released selected estimates of health insurance coverage for the civilian noninstitutionalized U.S. population based on data from the 2014 National Health Interview Survey (NHIS), along with comparable estimates from the 2009–2013 NHIS. Estimates for 2014 are based on data for 111,682 persons.

Key Findings from the Report:

  • In 2014, 36.0 million persons of all ages (11.5%) were uninsured at the time of interview, 51.6 million (16.5%) had been uninsured for at least part of the year prior to interview, and 26.3 million (8.4%) had been uninsured for more than a year at the time of interview.
  • Among persons under age 65, 63.6% (170.4 million) were covered by private health insurance plans at the time of interview. This includes 2.2% (5.9 million) covered by private plans through the Health Insurance Marketplace or state-based exchanges at the time of interview between January and December 2014. The proportion with exchange coverage increased from 1.4% (3.7 million) in the first quarter of 2014 (January–March) to 2.5% (6.7 million) in the fourth quarter of 2014 (October–December).
  • Among adults aged 18–64, the percentage who were uninsured at the time of interview decreased from 20.4% in 2013 to 16.3% in 2014.
  • Among adults aged 19–25, the percentage who were uninsured at the time of interview decreased from 26.5% in 2013 to 20.0% in 2014.
  • In 2014, the percentage of persons under age 65 who were uninsured at the time of interview varied by state. For example, 2.5% were uninsured in Hawaii, whereas 21.5% were uninsured in Oklahoma and Texas.

 


Insurance Status by State Medicaid Expansion Status: Early Release of Estimates From the National Health Interview Survey, 2013–September 2014

May 21, 2015

Under the Affordable Care Act, states have the option to expand Medicaid coverage to all eligible persons with incomes up to 138% of the federal poverty level (FPL). Previous research has shown that there have already been significant decreases in the percentages of persons who were uninsured between 2013 and the first 9 months of 2014.

Using data from 2013 and the second and third quarters (April through September) of the 2014 National Health Interview Survey (NHIS), a new NCHS report examines changes in the percentage of persons who were uninsured, by state Medicaid expansion status, age, and poverty status.

Data from the second and third quarters of the 2014 NHIS were chosen for this analysis because they capture the surge in enrollment in the Health Insurance Marketplace and state-based exchange plans that occurred in March and the beginning of April 2014. Data from the fourth quarter of the 2014 NHIS are not yet available.

Key Findings from the Report:

  • The percentage of adults aged 18–64 who were uninsured at the time of interview decreased from 20.4% in 2013 to 15.9% in April–September 2014.
  • Adults aged 18–64 with family incomes less than or equal to 138% of the FPL in Medicaid expansion states had a larger decrease in the percentage uninsured (10.2 percentage points) than those with similar income in nonexpansion states (3.3 percentage points) from 2013 to April–September 2014.
  • Between 2013 and April–September 2014, the percentage of uninsured adults aged 18–34 with incomes less than or equal to 138% FPL decreased 9.1 percentage points in Medicaid expansion states, compared with only 0.7 percentage points in nonexpansion states.
  • The greatest absolute decrease in the percentage uninsured from 2013 to April–September 2014 (12.1 percentage points) was among adults aged 45–64 with incomes less than or equal to 138% FPL in Medicaid expansion states.

 


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